In this week’s summary, you’ll find a new program to provide care to dual eligible’s, a cancer patient who found success in a clinical trial, guidelines for orgs who want to help the state educate the public on the health exchange, and more!
The New York State Medicaid Update is available here. It’s brief this month and does cover aspects of the new Medicaid pharmacy mail order law implementation as well as billing guidelines in Medicaid fee for service for drugs that are administered by practitioners.
The Centers for Medicare and Medicaid Services released this memorandum of understanding between CMS and New York State for a capitated financial alignment model for Medicare and Medicaid enrollees. In other words, New York received approval this week for its proposed pilot to enroll 170,000 dual eligible individuals in a capitated long-term care program, or the Fully Integrated Duals Advantage (FIDA) program. FIDA will begin in Long Island, Westchester and New York City no sooner that July 1, 2014.
Read how a phase II clinical trial saved this writer’s life in the New York Times. Saleika Jaquad is a regular contributor to the Times’ Well Blog, penning a series called “Life, Interrupted”, about her struggles with cancer. When all treatments failed, the author reluctantly agreed to enter a clinical trial and is now cancer-free.
New York’s I-Stop law went into effect on Tuesday, August 27, 2013 and requires doctors, physician assistants and nurse practitioners to consult the statewide drug database before issuing prescriptions for pain medications. Pharmacists are also required to record pain medication prescriptions that the pharmacy fills.
Affordable Care Act/Health Insurance Exchanges
New York’s health exchange website, NY State of Health is offering these co-branding guidelines for organizations to use in helping to distribute educational and marketing materials to the public.
Kaiser Health News reports on the issuance of final regulation implementing the individual mandate requirement of the federal health law, which requires individuals to obtain health insurance coverage by January 1, 2014 or face a fine. The new regulations outline nine categories of exempted individuals. These final regulations were issued by the Treasury Department and the Internal Revenue Service and are in addition to regulations issued in June by the Department of Health and Humans Services.
Kaiser Health News issued this breaking story that the Health and Human Services (HHS) Administration has issued the first federal guidelines regarding same-sex couples since the Supreme Court struck down the Defense of Marriage Act (DOMA). The new guidelines concerned same sex couple Medicare Advantage coverage for nursing home care. The Internal Revenue Service also issued tax filing guidelines for same sex couples.
-Jaime Venditti, 8/30/13